White Stephen F, Tillett Natasha D, Ogunsusi Monica T, Yawn Robert J
Department of Otolaryngology University of Tennessee Health Science Center Memphis Tennessee USA.
College of Medicine, University of Tennessee Health Science Center Memphis Tennessee USA.
Laryngoscope Investig Otolaryngol. 2023 Apr 28;8(3):754-757. doi: 10.1002/lio2.1054. eCollection 2023 Jun.
To describe a case of bifid intratemporal facial nerves without associated middle or inner ear abnormalities encountered on computed tomography (CT) imaging during preoperative preparation for unilateral cochlear implant placement in an adult male with profound sensorineural hearing loss (SNHL).
A rare case of bilateral bifid intratemporal facial nerves in an adult male is presented. The finding's impact on approach to safe cochlear implantation is discussed.
Bifurcation of the intratemporal facial nerve is rarely seen and is usually associated with congenital middle or inner ear anomalies. A unique case of bilateral bifid intratemporal facial nerves without other middle or inner ear abnormalities was encountered incidentally on CT imaging during preparation for unilateral cochlear implant placement in an adult male with profound SNHL. The nerve was bifid along the mastoid segment with a nerve branch traversing through the facial recess precluding safe traditional approach to cochlear implant placement. Accessory stylomastoid foramina were noted bilaterally. Unilateral subtotal petrosectomy was performed with successful implantation and excellent hearing outcome. No additional clinical or radiographic otologic abnormalities were noted.
Abnormal bifurcation of the facial nerve may occur in adults without other middle or inner ear anomalies. This case highlights the importance of independent imaging review by the surgeon and vigilance to potential rare anatomic aberrations of the facial nerve during cochlear implantation.
IV.
描述一例在为一名患有重度感音神经性听力损失（SNHL）的成年男性进行单侧人工耳蜗植入术前准备的计算机断层扫描（CT）成像中发现的颞内面神经分叉且无相关中耳或内耳异常的病例。
报告一例成年男性双侧颞内面神经分叉的罕见病例。讨论了该发现对安全进行人工耳蜗植入手术方法的影响。
颞内面神经分叉很少见，通常与先天性中耳或内耳异常有关。在为一名患有重度SNHL的成年男性进行单侧人工耳蜗植入术前准备的CT成像过程中，偶然发现了一例独特的双侧颞内面神经分叉且无其他中耳或内耳异常的病例。该神经在乳突段分叉，有一个神经分支穿过面神经隐窝，这排除了安全进行传统人工耳蜗植入手术的方法。双侧均发现有副茎乳孔。进行了单侧次全岩骨切除术，植入成功且听力结果良好。未发现其他临床或影像学耳部异常。
面神经异常分叉可能发生在无其他中耳或内耳异常的成年人中。该病例强调了外科医生独立进行影像学评估的重要性，以及在人工耳蜗植入过程中对面神经潜在罕见解剖变异保持警惕的重要性。
IV级
